The disclosed relates to devices, systems and methods relating to uses in cardiopulmonary resuscitation and other cardiological and pulmonary applications. More specifically, the various embodiments and implementations relate to a novel catheter, system and methods of use for occlusion and perfusion of a region of the circulatory system.
Cardiopulmonary resuscitation (“CPR”) by external chest compression, represents an area that has experienced little progress over the last 50 years. Despite relatively poor outcomes, physicians continued to perform the same technique in resuscitating cardiac arrest patients without any substantial changes.
One major downside of using early CPR is the inability to deliver blood supply with sufficient perfusion pressure to the brain. While the primary goal of early CPR is to provide oxygenated blood to the brain and cardiac muscle in order to prevent the deleterious sequelae of brain ischemia and to facilitate a fast return of normal cardiac function, the current resuscitation procedures are inadequate in both tasks. Reports abound of poor post-resuscitation survival rates and poor neurological outcomes for those who survive. Patients who undergo chest compression for over 20 minutes are less likely to survive without neurological deficits, which means there is only a narrow window for intervention before a permanent damage takes place.
Extracorporeal membrane oxygenation (“ECMO”) is an established procedure that has shown promising results in patients with cardiac arrest. Using ECMO in CPR (“ECPR”) was associated with improved outcomes compared to conventional CPR with significantly better survival to hospital discharge, better neurological outcomes and better long-term survival. Nevertheless, ECMO and ECPR require a highly trained team for implementation. Additionally, supporting the circulation with ECMO entails the placement of multiple large bore vascular access catheters of up to 10 mm in diameter. These large bore catheters can only be placed by healthcare professionals with very high level of training and extensive expertise. Further, ECMO teams are only available in highly equipped medical centers, which inherently limits ECMO use in addressing events outside of these settings.
For example, trauma is estimated to cause over five million deaths every year worldwide, with bleeding considered to be the leading preventable cause of death. The disclosed catheter has the potential to save the lives of traffic accident patients who have active bleeding by maintaining the heart and brain perfusion until the patient can get a definitive intervention. Similarly, limited ECMO might be useful in battlefield hospitals, where there is a great need to provide a temporary support to the vital organs' circulation in a bleeding patient until transportation is available. Other uses for the disclosed embodiments include major vascular surgical procedures, where creating an isolated vascular compartment is helpful, and as a back-up circulatory support in high-risk coronary artery interventions.
Accordingly, there is a need in the art for improved means of resuscitation. The various implementations can help to improve these outcomes.